Table 4.
Gestational age and preterm indication among births with dual burden of severe maternal morbidity and preterm birth by insurance type, California 2007–2012
| Characteristic | Medi-cal | Private | Uninsured | Othera | ||||
|---|---|---|---|---|---|---|---|---|
| n = 1,462,463 | n = 1,431,956 | n = 64,507 | n = 100,149 | |||||
| n | % | n | % | n | % | n | % | |
| < 28 weeks gestational age | 7,742 | 0.53 | 6,670 | 0.47 | 552 | 0.86 | 597 | 0.60 |
| PPROM | 2,566 | 0.18 | 2,344 | 0.16 | 176 | 0.27 | 164 | 0.16 |
| Preterm labor without PPROM | 4,557 | 0.31 | 3,703 | 0.26 | 316 | 0.49 | 391 | 0.39 |
| Medically indicated | 457 | 0.03 | 522 | 0.04 | 43 | 0.07 | 31 | 0.03 |
| Unknown | 162 | 0.01 | 101 | 0.01 | 17 | 0.03 | 11 | 0.01 |
| 28 to < 32 weeks gestational age | 11,240 | 0.77 | 11,411 | 0.80 | 617 | 0.96 | 819 | 0.82 |
| PPROM | 3,039 | 0.21 | 3,411 | 0.24 | 171 | 0.27 | 211 | 0.21 |
| Preterm labor | 6,506 | 0.44 | 6,389 | 0.45 | 335 | 0.52 | 515 | 0.51 |
| Medically indicated | 1,362 | 0.09 | 1,432 | 0.10 | 86 | 0.13 | 80 | 0.08 |
| Unknown | 333 | 0.02 | 179 | 0.01 | 25 | 0.04 | 13 | 0.01 |
| 32 to < 37 weeks gestational age | 106,640 | 7.29 | 108,643 | 7.59 | 4,972 | 7.71 | 7,674 | 7.66 |
| PPROM | 19,358 | 1.32 | 25,344 | 1.77 | 985 | 1.53 | 1,295 | 1.29 |
| Preterm labor | 58,227 | 3.98 | 56,327 | 3.93 | 2,576 | 3.99 | 4,468 | 4.46 |
| Medically indicated | 20,578 | 1.41 | 21,509 | 1.50 | 858 | 1.33 | 1,400 | 1.40 |
| Unknown | 8,477 | 0.58 | 5,463 | 0.38 | 553 | 0.86 | 511 | 0.51 |
| 37 to 38 weeks gestational age | 408,302 | 27.90 | 377,844 | 26.39 | 18,506 | 28.69 | 28,362 | 28.32 |
| 39 to 42 weeks gestational age | 927,227 | 63.40 | 926,575 | 64.71 | 39,795 | 61.69 | 62,610 | 62.52 |
| 43 to 44 weeks gestational age | 1,312 | 0.09 | 812 | 0.06 | 65 | 0.10 | 87 | 0.09 |
Dual burden defined as concomitant severe maternal morbidity or maternal in-hospital death and preterm birth (< 37 weeks). Severe maternal morbidity was determined according to the CDC algorithm + birth certificate: (1) in-hospital deaths, regardless of length of stay; (2) #19–25 without regard to length of stay; (3) #1–18 with length of stay restriction (≥ 90th percentile for type of birth with length of stay calculated separately for vaginal birth, primary cesarean, and repeat cesarean); or (4)#1–25 on postpartum readmission regardless of length of stay). Gestational age and prematurity categories are provided for descriptive purposes only and are not included in subsequent tables or as covariates in adjusted analyses. PPROM: Preterm premature rupture of the membranes
aOther insurance includes: Indian Health Service, CHAMPUS or TRICARE, other local, state, or federal insurance, or charity